Ontario public health measures
COVID-19 Info | Information sur la COVID-19 | COVID-19 Vaccine Vaccine Receipt | COVID-19 Self-Assessment

Middlesex-London Health Unit

Inner Nav

COVID-19 Guidance and Resources for Long-Term Care Homes and Retirement Homes

Note: Long-Term Care and Retirement Homes should contact their Middlesex-London Health Unit investigator with any questions or concerns regarding COVID-19 or other infectious diseases by calling 519-663-5317.


Guidance for Long-Term Care and Retirement Homes

Visitors to Long-Term Care Homes and Retirement Homes

Effective February 21, 2022:

  • General visitors five years of age and older who have had at least two doses of COVID-19 vaccine can visit long-term care residents.
  • The number of visitors permitted at a time, per resident increases from two to three, including caregivers.
  • All residents, regardless of vaccination status, can resume social day trips.
  • Residents who have had at least three vaccine doses can enjoy overnight social absences.
  • Adult day programs can resume along with the return of entertainers and external personal care services in the homes.
  • Social group activities should remain small, with up to 10 individuals.

Effective March 14, 2022:

  • General visitors under five years of age can resume visits.
  • The number of visitors at a time, per resident, increases from three to four, including caregivers.
  • All residents regardless of their vaccination status, can enjoy social overnight absences.

For more information:

Recent Updates to Retirement Home Visiting Policy

Effective December 22, 2021, all general visitors and support workers entering the retirement home will be required to take a rapid antigen test prior to entering, regardless of vaccination status.  The Provincial Government also strongly encourages retirement homes to require general visitors to be fully vaccinated and implement additional requirements for essential and general visitors who aren't fully vaccianted prior to entering the home.

For more information: Retirement Homes Policy to Implement Directive #3

Guidance for Long-Term Care and Retirement Homes from the Middlesex-London Health Unit

The Middlesex-London Health Unit strongly recommends the following for all Long-Term Care Homes (LTCHs) and Retirement Homes (RHs) in London and Middlesex County:

  • Student placement and activities in LTCHs and RHs must cease for the duration of an outbreak unless there is critical need for staff such that students are necessary for ongoing operation. In this instance, students will then be treated as 'employees' and will not be permitted to train or work at any other health care facility.
  • Residents should wear a mask anytime they are outside of their rooms.

Additionally, given the rising incidence of COVID-19 in the community, the Middlesex-London Health Unit has updated its quarantine guidance for household members of individuals with COVID-19-like symptoms. All household contacts of symptomatic individuals are to quarantine while awaiting the test results of the symptomatic individual. For Long-Term Care and Retirement Homes, the follow guidance now applies:

  • If a staff member's household member is symptomatic, the staff member should not go to work until the symptomatic person's test results are known.
  • If the test results are negative, the staff member may return to work and their normal activities and monitor themselves for the development of symptoms.
  • In exceptional circumstances where clinical care would be severely compromised without additional staffing, work-quarantine may be considered. Additional directions on work-quarantine can be found here.

COVID-19 Testing for LTCHs and RHs

Long-Term Care Homes

For full details about long-term care home surveillance testing and access to homes, please read the Minister's directive.

Retirement Homes

Effective December 22, 2021, retirement homes will require rapid antigen testing for staff, volunteers, contractors and essential caregivers, regardless of vaccination status, two times per week prior to entry into the home. Learn more →

The Retirement Homes Regulatory Authority (RHRA) recommends that "retirement homes have a policy on a routine asymptomatic screen test program that takes into account the risks and benefits of voluntary, routine, asymptomatic testing and aligns with their resources and needs, as determined by licensees." For full details of what the policy should include, read: RHRA Recommendation for Asymptomatic COVID-19 Screen Testing for Retirement Homes.

COVID-19 swab ordering process:

Healthcare Materials Management Services (HMMS) has assumed the distribution and delivery of COVID-19 swabs to all organizations across Ontario.

  1. Complete this electronic form and submit it online. HMMS will fulfill order requests within 72 hours and will have the COVID-19 swabs delivered to your facility.
  2. To ensure enough COVID-19 swabs are available for all organizations, please restrict orders to a maximum of 110% of your resident and staffing numbers combined, over a one-week period.
  3. If you have any questions or concerns regarding this process, contact HMMSCovid19@hmms.on.ca 

(back to top)

Long-Term Care Vaccine Education Program

All long-term care home operators must comply with the Minister’s Directive: Long-term Care Home COVID-19 Immunization Policy.

The Health Unit has prepared an educational program about:

  • The impact of COVID-19;
  • How COVID-19 vaccines work;
  • Vaccine safety related to the development of the COVID-19 vaccines;
  • The benefits of vaccination against COVID-19;
  • The risks of not being vaccinated against COVID-19;
  • Possible side effects of COVID-19 vaccination; and
  • How to get vaccinated.

Click here to access the session

Additional resources you may find helpful include:

COVID-19 Information
Viral Vector Vaccines
mRNA vaccines
How vaccines safety is monitored in Canada
Facts about COVID 19 vaccines

Personal Protective Equipment (PPE)

Staff masking:

  • All staff and essential visitors must wear surgical/procedure masks at all times for the duration of full shifts or visits in the long-term care and retirement home.

The following videos provide a refresher on the correct procedures for donning and doffing:

Email Updates and Alerts

The staff of long-term care and retirement homes can subscribe to receive email updates and alerts by emailing healthcareproviders@mlhu.on.ca with the subject line "add to LTC and RH distribution list" and let us know at which facility you're employed. To read previous alerts sent by email, please click the link below.

See Past Alerts (Email Archive)


Guidance Documents

For general guidance on: Environmental Cleaning, Personal Protective Equipment, and Infection Prevention and Control; Screening, Symptoms, Testing, and Case Management; and Quarantine and Self-Isolation, visit the Guidance and Setting-Specific Resources for Healthcare Providers and Institutions. 



Long-Term Care Homes and Retirement Homes Date

COVID-19 guidance document for long-term care homes in Ontario 
(Ontario Ministry of Long-Term Care)

As updated

COVID-19: Information for visitors to long-term care homes 
(Ontario Ministry of Long-Term Care)

As updated

COVID-19: Long-term care home surveillance testing and access to homes
(Ontario Ministry of Long-Term Care)

As updated

Minister’s Directive: Long-term care home COVID-19 immunization policy
(Ontario Ministry of Long-Term Care)

As updated

COVID-19 Directive #3 for Long-Term Care Homes under the Long-Term Care Homes Act, 2007
(Chief Medical Officer of Health)

May 3, 2022

COVID-19 Guidance: Long-Term Care Homes and Retirement Homes for Public Health Units
(Ontario Ministry of Health)

April 13, 2022

COVID-19 Screening Tool for Long-Term Care Homes and Retirement Homes
(Ontario Ministry of Health)

March 18, 2022

Cohorting During an Outbreak of COVID19 in Long-Term Care Homes
(Public Health Ontario)

March 11, 2022

COVID-19 Directive #5: Questions and Answers
(Ontario Ministry of Health)

December 20, 2021

COVID-19 Directive #5 for Hospitals within the meaning of the Public Hospitals Act and Long-Term Care Homes within the meaning of the Long-Term Care Homes Act, 2007
(Chief Medical Officer of Health)

December 17, 2021

Interim Guidance for Infection Prevention and Control of SARS-CoV-2 Variants of Concern for Health Care Settings
(Public Health Ontario)

August 2021

Prevention and Management of COVID-19 in Long-Term Care and Retirement Homes
(Public Health Ontario)

August 2021

Omicron – Interim COVID-19 infection prevention and control in the health care setting when COVID-19 is suspected or confirmed

(Guidance documents from the Government of Canada)

December 23, 2021

Using Ventilation and filtration to reduce aerosol transmission of COVID-19 in long-term care homes 
(Government of Canada)

April 12, 2021
COVID-19 Information for the Long-Term Care (LTC) Sector
(Ministry of Health)
Guide for Visits
(Ontario Ministry of Long-Term Care)
September 9, 2020
Posters to Retirement Homes
(Government of Ontario)
July 20, 2020

COVID-19 Test Requisition
(Ontario Health)

*Note: these instructions are for how to properly complete a test requisition form.  The form itself can be found here

June 12, 2020
Work Deployment Measures in Long-Term Care Homes
(Ontario Regulation)
July 15, 2020
Work Deployment Measures in Retirement Homes
(Ontario Regulation)
July 15, 2020
Infection Prevention and Control for COVID-19: Interim Guidance for Long Term Care Homes (Government of Canada) Check link for updates
Date of creation: April 2, 2020
Last modified on: March 11, 2022